摘要
目的分析“非正常工作时间”就诊对ST段抬高心肌梗死(STEMI)患者救治效率和预后的影响。方法纳入2014年6月—2018年6月就诊于成都市第三人民医院且在该院行直接经皮冠状动脉介入治疗的STEMI患者418例,根据就诊时间分为“正常工作时间”组134例和“非正常工作时间”组284例。比较两组患者的临床特征、早期救治效率和院内死亡率。结果在418例行直接经皮冠状动脉介入治疗的STEMI患者中,“非正常工作时间”组284例(67.9%)。与“正常工作时间”组相比,“非正常工作时间”组症状发作至球囊开通时间≤180 min的患者比例更高(53.2%vs 42.5%,P<0.05),门-球时间≤90 min的比例更低(38.4%vs 51.5%,P<0.05),而院内死亡率更高(4.58%vs 0.75%,P<0.05)。多因素逻辑回归分析提示:“非正常工作时间”就诊为患者院内死亡的独立危险因素(OR=11.562,95%CI 1.018~131.362,P=0.048)。结论在“非正常工作时间”来院就诊的STEMI患者院内死亡率更高。
Objective To evaluate the association between off-hour presentation and treatment efficiency and in-hospital mortality in patients with ST segment elevation myocardial infarction(STEMI).Methods We analyzed 418 consecutive patients with STEMI who were treated with percutaneous coronary intervention from June 2014 to June 2018 in The Third People's Hospital of Chengdu.According to the visiting time,134 cases were divided into“on-hour”group and 284 cases into“off-hour”group.The clinical characteristics,early treatment efficiency and hospital mortality of the two groups were compared.Results Among 418 STEMI patients who underwent primary PCI,284(67.9%)were in the“off-hour”group.Compared with the“on-hour”group,the proportion of patients with symptom to balloon time≤180 min in the“off-hour”group was higher(53.2%vs 42.5%,P<0.05),the proportion of patients with door to balloon time<90 min is lower(38.4%vs 51.5%,P<0.05),and the in-hospital mortality is higher(4.58%vs 0.75%,P<0.05).Multivariate logistic regression analysis revealed that off-hour presentation is an independent risk factor for in-hospital mortality(OR=11.562,95%CI 1.018~131.362,P=0.048).Conclusion STEMI patients who come to hospital during“off-hour”have higher in-hospital mortality.
作者
熊波
成联超
蔡琳
周名纲
陈应忠
XIONG Bo;CHENG Lianchao;CAI Lin;ZHOU Minggang;CHEN Yingzhong(Department of Cardiology,The Third People s Hospital of Chengdu,The Affiliated Hospital of Southwest Jiaotong University,Chengdu 610031,Sichuan,China;Southwest Jiaotong University College of Clinical Medicine,Chengdu 610031,Sichuan,China)
出处
《心血管病学进展》
2021年第9期853-858,共6页
Advances in Cardiovascular Diseases
基金
四川省应用基础研究项目(2018JY0126)。
